Formative research methods to understand patient and provider responses to heart attack symptoms

Formative research is often required for program planning, and for reducing uncertainty about generalizability of program effects. This article describes and justifies methods of formative research conducted for the REACT study (Rapid Early Action for Coronary Treatment), a multi-center collaborative randomized community trial aimed at reducing patient delay in seeking care for acute myocardial infarction (AMI). Formative research cast light on patient and community members’ decision-making process in seeking help for AMI, as well as barriers and facilitators of this process. Investigators at all five REACT Field Centers participated in the formative research. The process consisted of: (1) developing a common theoretical framework for the study intervention; (2) conducting a literature review and qualitative research to identify and address gaps in knowledge; and (3) developing a common protocol for the REACT study that accommodated the diversity of the target communities in terms of services, resources, history, and ethnicity. Analysis employed triangulation, defined as an explicit search for heterogeneous data sources to reduce uncertainty about forces at work and opportunities for intervention across settings and populations. Because the collection and interpretation of data went in stages, staff of several REACT Field Centers had independent input to the overall synthesis, then shared and revised the results. Advantages and limitations of this approach are discussed.     

Supportive Housing for Addicted,Incarcerated Homeless Adults

ABSTRACT

Homeless populations often suffer from mental illness, substance abuse, and criminality. Interventions, such as supportive housing, can have positive impacts, although benefits can be limited. This study examined outcomes for clients (N = 102) of a new supportive housing intervention. Use of formal treatment, jail contact, and community stability were compared pre- and post-housing. Jail bookings and residential substance abuse treatment significantly declined post-housing, while clients improved in income level, access to food, and housing stability. Results from official justice and treatment system data suggest that supportive housing can lead to significant changes. Future research is necessary to understand the relationship between client characteristics and outcomes.     

Excluding Children: Autonomy, Friendship and the Experience of the Care System

The concept of social exclusion is increasingly important in policy and research but has rarely been addressed from a child-centred perspective. Childhood is a social experience in itself, one that has its own norms and customs, and where the demands of participation and inclusion may be considerable, likewise the costs of exclusion. This paper explores the meaning and experience of social exclusion for children by focusing on a particular group of children and young people, those 'looked after' in the public care system. The sample involved children who had minimal contact with their parents, and who although not currently materially poor were vulnerable to a high future risk of experiencing poverty. They thus provided a valuable opportunity to explore some of the relational aspects of social exclusion. Using in-depth interviews to explore the meaning of friendship in their lives, the study revealed the importance of social relationships for these children, andin particular the impact of the care system on their capacity to make and sustain social networks. The findings suggest that the relational aspects of poverty are not just consequences of material poverty but can have a dynamic of their own, one that may have a particular resonance for children. This has implications not just for children in the care system, but also for children in families, where family poverty and the restricted social and economic integration of parents may also have an impact on children's capacity for developing social relationships and wider social networks.     

Achievement in a Relational Context: Preferences and Influences in Female Adolescents

Friends' influence on achievement‐related choices in female adolescents was investigated using the Thematic Apperception Test (H. Murray, 1943), in the context of self‐in‐relation theory (J. V. Jordon, A. G. Kaplan, J. B. Miller, I. P. Stiver, & J. L. Surrey, 1991). Two hypotheses were tested: (1) Achievement‐related stimuli will elicit stories with more unfavorable and conflicted outcomes than will affiliation stimuli; (2) Thematic representation of achievement will be more homogeneous in more highly cohesive peer groups. A multivariate analysis of variance with repeated measures yielded significant results for Hypothesis 1. Thematic analysis of stories supported Hypothesis 2, showing peer group influence on achievement strivings in female adolescents.     

'My Mum and Dad said it Calms You Down': Children's Perceptions of Smoking as a Coping Strategy

While studies have shown that adults use smoking to deal with stress, little research has been carried out with children to explore their perceptions of smoking as a coping strategy. Qualitative questionnaire and interview data were generated with children aged 9–11 years. Participants perceived that adults smoked to relieve boredom and stress, and suggested that children might smoke for the same reasons. Children were more likely to know that adults smoked to deal with stress if they lived in a deprived area. Girls were more likely to believe that some children need to smoke as a coping strategy.     

Puberty in the Last 25 Years: A Retrospective Bibliometric Analysis

Puberty research has been highly productive in the past few decades and is gaining momentum. We conducted an analysis of bibliographic data, including titles, abstracts, keywords, indexing terms, and citation data to assess the sheer numbers, audience and reach, publication types, and impact of puberty‐related publications. Findings suggest that puberty‐related publications are increasing in sheer numbers, and have reach in many fields as befits an interdisciplinary science. Puberty‐related publications typically have higher impact in terms of citations than the journal averages, among the journals that published the most studies on puberty. Limitations of the field and recommendations for researchers to improve the impact and reach of puberty‐related publications (e.g., clear conclusions in abstracts, highlighting the importance of puberty) are discussed.     

The Resilient Survivor—A Student Social Worker's Journey on Placement

This paper represents the continuation of my ‘personal and professional journey’ from social work student to social work practitioner focusing on my first Practice Learning Opportunity (PLO). Recognising the potential impact of childhood sexual abuse (CSA) in a classroom environment is as important as the potential impact on actual practice learning and practice. This is salient in the real world of social work practice as the potential misuse of a painful childhood experience has greater ramifications. Utilising the ideas and assumptions of social constructionism (including context and multivocality) the significance of silence from social work educators shall be examined in relation to self-disclosure as a means of aiding PLO learning and practice. This paper will also focus on the concept of critical reflection and its significance in exploring the transferability of a childhood experience such as CSA and personal and professional dilemmas regarding self-disclosure. This paper concludes by highlighting areas for consideration for both students and social work educators and conveys an important message regarding the importance of communication between students and social work educators.     

Anti-statism and Difference Feminism in International Social Movements

Feminist strategies that neglect or consistently deplore state action cannot accomplish what women need – because individuals need collectives such as states to solve collective action problems and to move toward more just social arrangements. Strategies that rely heavily on women's differences from men also cannot accomplish what women need – because women are like men in many ways relevant to individual and collective action. Despite these truths, social movements also need some strategies of action that work separately from and sometimes against the state. Moreover, strategies that accentuate the differences between oppressed and oppressing bring needed energy to a movement. The best overall strategy is, therefore, to realize that both states and difference theories are dangerous weapons, and proceed with caution.